Ideally, procedures for performing surgery to remove tonsils or adenoids (sometimes hereinafter collectively referred to as "organs") should be fast, should be as painless and non-traumatic as possible during surgery, should be painless after surgery, should be bloodless both during and after surgery and should facilitate rapid recovery of the patient. Rapid recovery includes absence of infection, minimum weight loss during the post-operative period, and a rapid return to normal activity. With current concerns on medical costs, the procedure should also be as inexpensive to perform as possible.
Unfortunately, current surgical procedures, which generally involve the use of a knife or other "cold" instrument, an electrocautery or a laser to separate the tonsil or adenoid, from surrounding tissue so that the organ can be physically removed, do not succeed in achieving any of these objectives. First, the pain and trauma level during surgery is such that these procedures must normally be performed under a general anesthesia. This significantly increases the cost of the procedure since it requires the services of an anesthesiologist and requires that the procedure be performed in a hospital operating room. The requirement to use a general anesthesia also increases the time required to perform the procedure, which normally lasts approximately thirty minutes, but may last significantly longer, can cause sickness and discomfort when the patient first comes out of the anesthesia, and in rare instances can result in the death of the patient. Further, since the procedure leaves an open wound, there may also be significant bleeding both during surgery and during the post-operative period, especially when the eschar falls off which may occur 3-5 days post-operative. For patients whose blood does not coagulate well, bleeding may occur for several days after the procedure, and in rare instances can even result in the death of the patient. Surgical procedures involving an open wound are a particular problem for hemophiliacs.
The wound created by the surgery also results in post-operative pain which, for a tonsil or adenoid procedure, is particularly noticed when the patient is swallowing. This pain makes it difficult for the patient to eat immediately after the procedure and may inhibit the ability of the patient to eat normally for several days thereafter. This can result in dehydration and weight loss for the patient; and the lack of good nutrition, coupled with the pain, can increase the time before the patient can return to normal activity.
Another potential problem with open wounds is infection. In order to prevent infection, patients are normally placed on antibiotics for some period of time after the surgery. In addition to the added cost of such antibiotics, it is known that increased use of antibiotics causes the development of infectious agents which are resistant to the antibiotics and makes it more difficult to treat the patient at a later date when the patient may have some type of serious, infectious illness.
Finally, there is the cost of such procedures. Even for a simple tonsillectomy or the combined removal of tonsils and adenoids, the cost for doctors and hospitals alone is in the $3,000.00 to $5,000.00 range. Since at least 340,000 tonsillectomies, either with or without adenoidectomies, are performed in the United States alone each year, making this the most frequently performed procedure in the United States, the total cost to the country is well over $1,000,000,000 a year and this does not include indirect costs such as lost work time and the like.
A need therefore exists for an improved procedure for removing tonsils and adenoids, which more closely approaches the ideal of being fast, painless, bloodless, low cost, and associated with rapid recovery. Such procedure should preferably be susceptible of performance in a doctor's office with no more than a local anesthetic and should be both safe to perform and simple to learn so as to minimize patient risk.